SFEBES2016 Poster Presentations Reproduction (33 abstracts)
Gonadotropin Induction of Spermatogenesis in Men with Hypogonadotrophic Hypogonadism: an audit
Pushpa Jinadev 1 , Tomas Ahern 1, , Lakshmi Pichaipillai 1 , Khaled Tofeec 1 , Christine Gibson 1 , Nicci Komlosy 1 & Frederick Wu 1
1Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; 2Christie Hospital, Manchester, UK.
Introduction: Infertility affects 15% of couples worldwide. Male factors account for half of cases seeking medical care.
Objectives and methods: To ascertain whether the American Association of Clinical Endocrinologists (AACE) guidelines regarding gonadotrophin induction of spermatogenesis in men with hypogonadism are being followed in our unit. Data were collected retrospectively from clinical records.
Results: 26 couples were identified. The presence of hypogonadotropic hypogonadism was confirmed by an endocrinologist in all cases. Assessment of the female partner’s fertility was recorded in 17 couples (65%).
Hypogonadotropic hypogonadism was due to a congenital cause in 54% of cases. βHCG was the initial therapy in all cases. In men with persistent azoospermia, recombinant follicular stimulating hormone (rFSH) therapy was added in 17 couples (65%) 9 months (median, range 6 to 16 months) after commencement of βHCG therapy.
Serum testosterone levels were measured and semen samples were analysed every 3.6±1.1 (mean±S.D.) months.
Pregnancy was achieved in 4 couples (15%) treated with βHCG monotherapy and in 7 couples (27%) in receipt of combination βHCG and rFSH therapy.
βHCG was continued until 2nd trimester in at least 8 couples (31%). Testosterone replacement therapy was restarted in 12 patients (46%).
Conclusion: Gonadotrophin induction of spermatogenesis in our unit is in line with AACE recommendations. This study shows that infertility due to secondary hypogonadism is treatable with exogenous Gonadotrophins. We also suggest that a dedicated unified proforma will enable us to follow the protocol for management of infertility and assist us for data collection for future studies.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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